Centre for Health and Society, Institute of Occupational Medicine and Social Medicine, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, Ulm, Germany.
Eur J Public Health. 2017 Dec 1;27(6):1021-1026. doi: 10.1093/eurpub/ckx068.
Little is yet known on the long-term effects of stress management interventions (SMIs) in the workplace. The aim this study was to prospectively examine the effect of an improvement of psychosocial working conditions measured by the Effort-Reward (E-R) Imbalance model within 2 years following an SMI, and mental health 7 years later.
The study sample consisted of 97 male industrial workers from southern Germany. Data were collected pre- and post-intervention in 2006 (T1) and 2008 (T2), respectively, as well as in 2015 (T3). Change scores were computed by subtracting T1 from T3 values. The associations between E-R ratio at T1, T2 and the change score, respectively, with depression and anxiety 7 years later were estimated by means of linear regression analysis. Analyses were adjusted for baseline levels of the exposure and outcome variables, socio-demographic-, health- and work-related covariates.
Within-person comparisons revealed a significant reduction (i.e. improvement) in E-R ratio post-intervention (-0.103, SD 0.24, P = 0.000). This improvement in the E-R ratio was significantly associated with lower anxiety (β = 0.358, P = 0.001) and depression (β = 0.246, P = 0.031) scores in the fully adjusted models. The association between change scores and mental health were slightly stronger than associations with absolute values at T1 and T2.
An improvement in E-R ratio following an SMI, was significantly associated with lower anxiety and depression 7 years later. These results strongly support the importance of improving psychosocial working conditions in order to protect the mental health of employees in the long-run.
目前对于职场压力管理干预（SMI）的长期效果知之甚少。本研究旨在前瞻性地检验在 SMI 后 2 年内通过努力-回报（E-R）失衡模型测量的心理社会工作条件的改善，以及 7 年后心理健康的效果。
研究样本由来自德国南部的 97 名男性产业工人组成。数据分别于 2006 年（T1）和 2008 年（T2）进行干预前和干预后收集，并于 2015 年（T3）再次收集。通过从 T3 值中减去 T1 值计算变化得分。采用线性回归分析估计 T1、T2 时的 E-R 比值与 7 年后抑郁和焦虑的变化得分之间的关联。分析调整了暴露和结局变量、社会人口学、健康和工作相关的协变量的基线水平。
个体内比较显示，干预后 E-R 比值显著降低（即改善）（-0.103，SD 0.24，P = 0.000）。E-R 比值的这种改善与焦虑（β = 0.358，P = 0.001）和抑郁（β = 0.246，P = 0.031）得分的显著降低相关。在完全调整的模型中，变化得分与心理健康之间的关联比 T1 和 T2 时的绝对数值的关联略强。
SMI 后 E-R 比值的改善与 7 年后焦虑和抑郁程度降低显著相关。这些结果强烈支持改善心理社会工作条件以保护员工心理健康的重要性。
